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A Doerfler

Publications and source records attributed to A Doerfler.

At least 19 recordsLinked to original sources
PubMed2006

Hypopituitarism following severe traumatic brain injury.

Although hypopituitarism is a known complication of traumatic head injury, it may be under-recognized due to its subtle clinical manifestations. To address this issue, we determine the prevalence of neuroendocrine abnormalities in patients rehabilitating from severe traumatic brain injury (Glasgow Coma Scale < or = 8). 76 patients (mean age 39 +/- 14 yr; range 18-65; 53 males and 23 females; BMI 25.8 +/- 4.2 kg/m2; mean +/- SD) with a severe traumatic brain injury, an average of 22 +/- 10 months before this study (median, 20 months), underwent a series of standard endocrine tests, including TSH, free T4, T4, T3, prolactin, testosterone (males), estradiol (females), cortisol, ACTH, GH, and IGF-I. All subjects also underwent GH response to GHRH + arginine. Growth hormone deficiency (GHD) was defined as a GH response < 9 microg/L to GHRH + arginine and was confirmed by ITT (< 3 microg/L). Pituitary deficiency was shown in 24% of the patients (18/76). 8% (n = 6) had GHD (GH-peak range [GHRH + arginine]: 2.8-6.3 microg/L; GH-peak range [ITT]: 1.5-2.2 microg/L; IGF-I range: 62-174 microg/L). 17% (n = 13) had hypogonadism (total testosterone < 9.5 nmol/L and low gonadotropins in 12 males; low estradiol, and low gonadotropins in 1 female). Total testosterone levels did not correlate with BMI or age. 2 males with hypogonadism also showed a mild hyperprolactinemia (33 and 41 ng/ml). 3% (n = 2) patients had partial ACTH-deficiency (cortisol-peak [ITT] 392 and 417 nmol/L) and 3% (n = 2) had TSH-deficiency. In summary, we have found hypopituitarism in one-fourth of patients with predominantly secondary hypogonadism and GHD. These findings strongly suggest that patients who suffer head trauma must routinely include neuroendocrine evaluations.

Adolescent↗
PubMed2006

Intradural-extramedullary cavernous hemangioma of the left motor root C7--case report and update of the literature.

OBJECTIVE: Intradural-extramedullary cavernomas of the spine are rare lesions with only 21 published cases to date. Due to their rareness and special characteristics diagnosis often is difficult. We report on an additional case of an intradural-extramedullary cavernoma of the spine. PATIENT: A 56-year-old male presented with left shoulder pain and acute onset of pain affecting the whole spinal column two weeks prior to admission. There were no motor deficits, but a hypesthesia corresponding to the right distal C8-dermatome. MRI revealed an intradural-extramedullary, expansive lesion at the level of C6 with a hyperintense appearance in both T (1)- and T (2)-weighted images. Neither a hemosiderin rim nor contrast enhancement was visible. RESULTS: During surgery a hematoma and a reddish, berry-like tumor adherent to the left motor root C7 were removed. There were no new neurological deficits, and shoulder and back pain resolved within a few weeks after surgery. Histopathologically a cavernous hemangioma was diagnosed. CONCLUSIONS: The patient's symptoms were caused both by direct nerve compression and by spinal hemorrhage, most likely spinal SAH. As there was no characteristic hemosiderin rim and due to the hyperintense appearance in T (1)- and T (2)-weighted MR scans, a radiological diagnosis of hemorrhage and classification of the lesion was difficult. Despite their rareness, in patients with signs of spontaneous, spinal SAH and/or nerve compression syndromes cavernous hemangiomas have to be considered as a potential cause.

Hemangioma, Cavernous, Central Nervous System↗
PubMed2006

Alveolar rhabdomyosarcoma of the clivus with intrasellar expansion: Case report.

Rhabdomyosarcomas are common tumors of the head and neck region in children. However, a primarily intracranial localization of this tumor entity is rare. We report on a 3-year-old boy presenting with double vision due to left VI (th) nerve palsy. No other neurological deficits were recognized by clinical inspection. MRI scans visualized an enhancing mass lesion in the upper clivus compressing the cavernous sinus and the pituitary gland. Transsphenoidal biopsy was performed and histopathological examination as well as molecular diagnostics confirmed the diagnosis of an alveolar rhabdomyosarcoma (ARMS). Staging identified a metastatic lesion in the fourth thoracic vertebra resulting in the diagnosis of stage IV disease. Treatment modality included stereotactic radio- and chemotherapy.

Abducens Nerve Diseases↗
PubMed2006

Endovascular treatment of middle cerebral artery aneurysms with electrolytically detachable coils.

BACKGROUND AND PURPOSE: Middle cerebral artery (MCA) aneurysms often have an unfavorable aneurysm geometry that might limit endovascular therapy. Our purpose was to analyze the feasibility, safety, and efficacy of coil embolization in a consecutive series of MCA aneurysms chosen for endovascular treatment. PATIENTS AND TECHNIQUES: Of 235 MCA aneurysms seen at our institution during the past 5 years, 36 patients harboring 38 MCA aneurysms were primarily selected for coil embolization: 18 patients had an acute subarachnoid hemorrhage (SAH), 16 of which were due to a ruptured MCA aneurysm. SAH was classified according to Hunt and Hess grade: I (5), II (7), III (5), IV (0), and V (1). RESULTS: Complete occlusion could be achieved in 33 of 38 aneurysms. In 5 aneurysms, coil embolization was not performed because of an unfavorable aneurysm geometry with a wide neck or incorporation of adjacent branches (3) or failed because of insecure coil placement (1) or severe vasospasm (1). Procedural complications included coil protrusion into the parent artery (1), and thromboembolic M2 occlusion (5), with recanalization in 4 of 5 cases. Of 8 aneurysms with initial subtotal occlusion, 3 progressed to total occlusion during follow-up. Three aneurysms had to be retreated, and no patient rebled. Glasgow Outcome Scale at 6 months for the patients with SAH (17/18) was good recovery (12), moderate disability (4), severe disability (0), persistent vegetative state (0), and death (1); outcomes for patients with an incidental aneurysm (17/18) were good recovery (16) and moderate disability (1). CONCLUSION: Endovascular coil embolization can be performed safely and effectively in selected MCA aneurysms. Initial subtotal aneurysm occlusion might progress to total occlusion.

Adult↗
PubMed2005

Intracranial hypotension due to leakage of cerebrospinal fluid: could myelography be a therapeutic option?

Spontaneous intracranial hypotension (SIH) is an uncommon condition caused by cerebrospinal fluid leakage. We report of a 29-year-old woman with typical symptoms in whom initial cranial MRI and CT were normal . A clinical diagnosis of SIH, but the symptoms did not resolve with conservative therapy or a lumbar epidural blood patch. Repeat MRI revealed (indirect) findings consistent with SIH but failed to directly demonstrate a cerebrospinal fluid fistula. Subsequent CT myelography revealed leakage of contrast medium into the epidural space bilaterally along the nerve roots at C3-7. Following the myelography the patient reported dramatic clinical improvement with complete resolution of symptoms. The adhesive quality of the myelographic contrast medium might have precipitated closure of the meningeal tears. Myelography may be not only of diagnostic value but also therapeutic in SIH.

Adult↗
PubMed2005

Endovascularly or surgically treated vertebral artery and posterior inferior cerebellar artery aneurysms: clinical analysis and results.

OBJECTIVE: To describe the clinical results in patients with aneurysms of the vertebral artery and posterior inferior cerebellar artery complex (VA-PICA) treated by endovascular embolization or surgically in cases considered untreatable by endovascular methods. PATIENTS AND METHODS: During a 5-year-period a total of 28 patients with a VA-PICA complex aneurysm out of 600 patients received definitive treatment, 19 patients by endovascular embolization and 9 patients surgically. Mean age was 54 years (range 9-75 years). Clinical data, intraoperative observations and procedural complications were evaluated. The mean follow-up was 9 months. RESULTS: Hunt-Hess (HH) grades were HH 0-II in 10 patients (35.7 %), HH III in 6 patients (21.4 %) and HH IV + V in 12 patients (42.9 %). Aneurysm size ranged from 2 to 40 mm (mean size 5.5 mm). Aneurysm configuration was saccular 18, fusiform 7 and multilobed 3. Complete occlusion was achieved in all cases. Overall 67.9 % (n = 19) showed a favorable outcome (Glasgow Outcome Score IV + V). Overall procedure-related rate for permanent morbidity and mortality was 3.6 % (n = 1) and 3.6 % (n = 1), respectively. Predictive factors of clinical outcome were the initial clinical HH grade and the Fisher grade. CONCLUSION: Endovascular embolization is an effective method for the treatment of VA-PICA aneurysms. Surgical clipping is still an alternative and should be considered for "uncoilable" lesions. Outcomes showed a close correlation to the initial clinical state and were not dependent on the treatment modality.

Adolescent↗
PubMed2005

Treatment of wide-necked intracranial aneurysms with a self-expanding stent: mid-term results.

PURPOSE: To evaluate mid-term clinical and angiographic results after using a self-expanding neurovascular stent and coils for the management of broad-based intracranial aneurysms. METHODS: During the period from August 2001 to October 2004 we treated a total of 42 patients with 44 aneurysms using a self-expandable stent. To date we have data on more than 6 months of follow-up in 25 patients with 26 aneurysms. Aneurysm occlusion was divided into the following categories: 100 % (complete), 95-99 % (subtotal), and < 95 % (incomplete). RESULTS: In 15 aneurysms complete occlusion, in 11 aneurysms subtotal occlusion was initially achieved. Control DSA showed progressive thrombosis in seven aneurysms leading to total occlusion in another 4 aneurysms. Three recanalizations were observed in one large and two giant ICA aneurysms. No vessel occlusion occurred. One vessel stenosis of the stented segment was noted, but it was not clinically relevant. One patient experienced a small embolic infarction after stopping antiplatelet medication. No persistent deterioration of the clinical status occurred. CONCLUSION: Combining a stent with coils seems to be an acceptable treatment option for broad-based intracranial aneurysms. As this special subgroup of treated aneurysms includes only those with an unfavourable geometry, the results are extremely promising.

Aneurysm, Ruptured↗
PubMed2004

Multimodal imaging in the elastase-induced aneurysm model in rabbits: a comparative study using serial DSA, MRA and CTA.

BACKGROUND AND PURPOSE: The elastase-induced aneurysm model in rabbits has proved to be suitable for testing new endovascular occlusion devices. The purpose of this study was to evaluate different imaging modalities for the depiction of anatomy and size of elastase-induced aneurysms and for serial follow-up imaging. MATERIALS AND METHODS: Elastase-induced aneurysms were created in eight Chinchilla bastard rabbits by endoluminal incubation of porcine elastase. Serial imaging was performed using intravenous DSA (IVDSA), contrast-enhanced MRA (CEMRA), and time-of-flight MRA (TOF) 14 days, 4 weeks and 3 months after aneurysm creation. Intraarterial DSA (IADSA) and CT angiography (CTA) were performed after 3 months. Aneurysm size and geometry (height H, width W, neck width N) were compared. RESULTS: On IVDSA after two weeks mean aneurysm height was 6.2 mm (range 2.8 - 11.0 mm), mean aneurysm width was 2.8 mm (range 2.0 - 4.2 mm) and mean aneurysm neck width was 2.7 mm (range 2.0 - 4.2 mm). We did not observed any statistically significant change in aneurysm dimensions during follow-up at 4 weeks (CEMRA: H: 5.4, W: 2.4, N: 2.4; TOF: H: 5.7, W: 2.4, N: 2.7) and 3 months (CEMRA: H: 5.8, W: 2.6, N: 2.6; TOF: H: 6.9, W: 2.8, N: 3.0). Aneurysm dimensions could be best seen on IADSA (H: 6.2, W: 3.0, N: 2.7) with good correlation to CTA (r = 0.94; H: 6.1, W: 2.8, N: 2.6), CE-MRA (r = 0.92), and TOF (r = 0.97). TOF was superior to CEMRA in delineating the aneurysm wall. CONCLUSIONS: Serial imaging using MRA, CTA or intravenous and intraarterial angiography is feasible in the elastase-induced aneurysm model. Contrast-enhanced MRA, TOF-MRA and CTA showed good correlation to IADSA and are all suitable for non-invasive pretherapeutic measurement of aneurysm size.

Angiography↗
PubMed2003

Wernicke's encephalopathy: unusual contrast enhancement revealed by magnetic resonance imaging.

Wernicke's encephalopathy is a serious neurologic disorder caused by vitamin-B1 or thiamine deficiency. The classical triad of clinical symptoms described by Wernicke (gait ataxia, ophthalmoplegia, and confusion) are found in only a third of patients upon initial examination. Typical findings upon MR imaging in patients with Wernicke's encephalopathy are well documented, with signal intensities in the medial thalami and periaqueductal regions of the midbrain. We report a case of Wernicke's encephalopathy revealing an unusual contrast enhancement. It is therefore important to note that the acute stage of Wernicke's encephalopathy may be associated with an intense contrast enhancement upon MR-imaging reflecting the disruption of the blood-brain barrier and inflammatory processes caused by thiamine deficiency. As a consequence from the guideline for managing Wernicke's encephalopathy by the Royal College of Physicians early B-vitamin treatment in suspected is recommended cases.

Acute Disease↗
PubMed2003

Multilocal magnetic resonance perfusion mapping comparing the cerebral hemodynamic effects of decompressive craniectomy versus reperfusion in experimental acute hemispheric stroke in rats.

This study examined the hemodynamic effects of craniectomy compared to reperfusion on the temporal evolution of cerebral perfusion in different brain regions in a rat model of focal cerebral ischemia. Three groups were investigated: no treatment, reperfusion or craniectomy at 1 h. Perfusion-weighted magnetic resonance imaging (PWI) was performed serially from 0.5 to 6 h. Relative regional cerebral blood flow was calculated for different regions and infarct volume was assessed by histology at 24 h. As conclusion, both, craniectomy and reperfusion increased cerebral perfusion in the acute phase of cerebral ischemia. While reperfusion resulted in a homogeneous improvement of perfusion in the cortex and basal ganglia, craniectomy improved only cortical perfusion in areas directly under the craniectomy site. PWI is well suited to non-invasively monitor perfusion alterations after aggressive therapeutical approaches in stroke.

Acute Disease↗
PubMed2003

Improvement of carotid blood flow after carotid endarterectomy--evaluation using intraoperative ultrasound flow measurement.

OBJECTIVES: to examine the relationship between the degree of extracranial internal carotid artery (ICA) stenosis and changes in the ipsilateral ICA blood flow after carotid endarterectomy (CEA). MATERIALS AND METHODS: in a prospective study we studied 51 patients with unilateral 60-99% ICA stenosis (median degree 84%, asymptomatic stenosis n = 13, symptomatic stenosis n = 38). The degree of ICA diameter stenosis was determined by ex-vivo plastination of the surgically removed atherosclerotic specimen and video-assessed planimetry. Intraoperative transit time ultrasound flow measurements of the carotid arteries were performed before and after CEA. Blood flow changes were assessed by mathematical approximations. Statistics were done by use of the Wilcoxon signed Rank test. RESULTS: common carotid artery (CCA) and ICA median blood flow increased after CEA from 370 and 130 ml/min to 450 and 282 ml/min, respectively (p <.001). The relative increase of ICA blood flow was 5% and 18% for 60-69% and 70-79% ICA stenosis (n.s.) but 70% and 247% for 80-89% and 90-99% stenosis (p <.001 each). Mathematical evaluation (fourth-polynomal function) determined a significant increase of carotid blood flow after CEA in ICA stenosis of > or =82.3%. CONCLUSIONS: in the absence of severe contralateral ICA occlusive disease a significant increase of ipsilateral ICA blood flow by CEA can be expected in patients with an ICA stenosis of > or =82.3% (linear degree of stenosis, ECST criteria).

Aged↗
PubMed2002

In-vivo measurement of cytochrome using NIRS during acute focal cerebral ischaemia and reperfusion in rats.

OBJECTIVES: Near-infrared spectroscopy (NIRS) based technology allows in-vivo monitoring of focal tissue cytochrome aa3 (cytochrome-c-oxidase). The aim of this study was to assess early cell alteration during acute focal cerebral ischaemia and reperfusion. METHODS: Focal cerebral ischaemia was induced in 12 rats using an endovascular occlusion technique of the middle cerebral artery (MCA). Occlusion time was 60 minutes followed by reperfusion for another 60 minutes. Monitoring of oxygen saturation (SO2) and oxidized cytochrome complex (oxid. Cytaa3 ) was performed by NIRS via a parietal burr hole before (baseline), during occlusion and reperfusion. Twenty-four hours after MCA occlusion (MCAO) infarction was confirmed by TTC staining. RESULTS: In all animals SO2 and oxid. Cytaa 3 immediately decreased to zero during occlusion indicating complete ischaemia. According to the results of NIRS measurements during reperfusion animals were subdivided into two groups. All animals of group A demonstrated identical or even higher levels of SO2 and oxid. Cytaa3 compared to baseline. On the contrary, both parameters in group B remained at a distinct lower level compared to baseline (p < 0.05). Average reperfusion/baseline ratios for SO2 and oxid. Cytaa 3 were 0.8 (+/- 0.4) and 0.4 (+/- 0.2), respectively. The results of TTC-staining were distributed to the above mentioned two groups as follows: group A, only lesions in the basal ganglia or little cortical infarction (n = 8); group B, lesions in the basal ganglia and cortical area (n =4). CONCLUSIONS: After 1 hour MCAO a subgroup of animals with associated cortical infarction was identified, whose oxid. Cytaa3 values did not reach baseline values during reperfusion indicating early intracellular disturbance.

Animals↗
PubMed2002

What is effective in malignant middle cerebral artery infarction: reperfusion, craniectomy, or both? An experimental study in rats.

BACKGROUND AND PURPOSE: We sought to evaluate the effects of reperfusion and craniectomy treatment at different time points after middle cerebral artery (MCA) occlusion on infarct volume and neurological outcome in MCA infarction in rats. METHODS: We used an endovascular technique to obtain MCA occlusion in 182 rats. Thirteen groups with 14 animals each were investigated: control group 1 with no treatment; groups 2 to 7 with only reperfusion or craniectomy at 1, 4, or 12 hours, respectively; and groups 8 to 13 with reperfusion at 1 or 4 hours combined with craniectomy at 1, 4, or 12 hours, respectively. We used infarct volume and neurological performance as study end points in all animals at day 7. RESULTS: Neurological score and infarct volume in animals undergoing early reperfusion at 1 hour were significantly smaller (1.8/79+/-59 mm3) than those in control animals (3.8/225+/-26 mm3) (P<0.01). Reperfusion at 4 hours (2.8/182+/-62 mm3) and 12 hours (3.7/231+/-69 mm3) did not result in significant improvement. Animals undergoing craniectomy at 1, 4, and 12 hours demonstrated significantly better outcome and significantly reduced infarct volume (1.6/96+/-30 mm3, 1.9/109+/-39 mm3, and 2.6/150+/-34 mm3, respectively) (P<0.05). Compared with 1 treatment at a time, combined reperfusion and craniectomy did not result in a significant additional benefit. CONCLUSIONS: Early reperfusion and craniectomy at 1 hour are both effective in large MCA infarction. While reperfusion later than 1 hour was not beneficial, late craniectomy at 4 and 12 hours still resulted in significant improvement of neurological score and reduction of infarction size. Combined treatment at different time points yields no significant additional benefit compared with 1 treatment at a time.

Acute Disease↗
PubMed2001

Flow-directed microcatheters for cerebral embolizations using Ethibloc--an in vitro study.

We conducted an in vitro performance study to test the flow-directed Spinnaker microcatheter for potential endovascular embolizations with Ethibloc as embolic agent. We performed in vitro testing using 50 Spinnaker 1.8F hydrophilic infusion microcatheters of three different types. As embolic agent, different mixtures of Ethibloc and Lipiodol (E/L 1:1, 1:2, 1:3) were used. In an in vitro setting, each catheter was injected to a maximum of ten times (E/L 1:1, n = 20 catheters; E/L 1:2, n = 20; E/L 1:3, n = 10). In addition, we evaluated the thinner Spinnaker 1.5F microcatheter (165/20, n = 10). Five Spinnaker 1.5F catheters were each injected with a mixture of Ethibloc and Lipiodol (E/L 1:2 and 1:3). When a mixture of E/L 1:1 was used, 9 of 20 (45%) Spinnaker 1.8F microcatheters ruptured distally near the tip of the microcatheter, each during injection nos. 5-9. One Spinnaker 1.8F was distally occluded after the fifth injection. With a mixture of E/L 1:2, 4 of 20 (20%) Spinnaker 1.8F microcatheters ruptured distally, during injection no. 6 (n = 2), 7 (n = 1), and 8 (n = 1). With a mixture of E/L 1:3, all ten Spinnaker 1.8F microcatheters could be injected without any problems. All ten microcatheters of the thinner Spinnaker 1.5F ruptured (10-18 cm proximally to the catheter tip). This in vitro study using the flow-directed Spinnaker microcatheter revealed that microcatheters can rupture. The Spinnaker 1.8F can rupture when a mixture of Ethibloc and Lipiodol 1:1 or 1:2 and more than four injections are used. The Spinnaker 1.8F does not rupture when a mixture of E/L 1:3 is used, or with a mixture of E/L 1:1 or 1:2 and injecting to a maximum of four times. The Spinnaker 1.5F microcatheter is not suitable for embolizations using Ethibloc. For embolizations with Ethibloc we therefore recommend the use of a guidewire-directed microcatheter.

Catheterization↗
PubMed2001

Cerebral aspergillosis: comparison of radiological and neuropathologic findings in patients with bone marrow transplantation.

Thirty-six lesions in six patients who died from cerebral Aspergillus infection after bone marrow transplantation (BMT) were studied with regard to signal intensity, contrast enhancement, size, and location. The diagnosis was confirmed in all cases by autopsy. Retrospective correlation of histopathological and radiological findings was possible for 14 lesions. Most of the lesions (22/36) had isointense to low signal intensity on T2-weighted images (T2WI). Histopathologically, hemorrhagic necrosis was determined in three of them. Areas of high signal intensity on T1-weighted images (T1WI) were related to gross hemorrhage. Two infarctions showed intravascular accumulation of fungal hyphae with secondary thrombosis of the vessel. The remaining 12 lesions had high signal intensity on T2WI and low on T1WI. Histopathologically, four were infectious and four were unspecific demyelinated lesions. In conclusion, cerebral aspergillosis typically presented with large lesions showing isointense to low signal intensity on T2WI that could have areas of high signal on T1WI. Contrast enhancement was only visible in 15 lesions, and the predominant locations were the subcortical white matter, the cerebellum, and the basal ganglia. Small lesions with high signal on T2WI and low signal on T1WI could not necessarily be related to Aspergillus infection.

Adolescent↗
PubMed2001

Perfusion-weighted magnetic resonance imaging in patients with carotid artery disease before and after carotid endarterectomy.

OBJECTIVE: The purpose of this study was to investigate the potential of perfusion-weighted magnetic resonance imaging for preoperative and postoperative evaluation of cerebral hemodynamics in patients undergoing carotid endarterectomy for carotid artery stenosis. METHODS: We examined 26 patients with angiographically proven stenoses (60%-99%) of the internal carotid artery preoperatively. Perfusion imaging studies were performed by bolus-tracking of a dosage of 0.2 mmol/kg body weight of gadolinium diethylenetriaminepentaacetic acid on a 1.5-T scanner using a T2*-weighted fast low-angle shot sequence. The observed signal intensities were converted pixel by pixel into concentration-time curves. In each patient, the hemispheres were compared and the difference between the normalized first moments (NFMs) and the percentage changes of the regional cerebral blood volume (CBV) were calculated. Three months postoperatively, perfusion-weighted magnetic resonance imaging was performed in 13 patients. RESULTS: In patients with <80% stenosis (n = 10), there was no significant alteration of NFM and regional CBV compared with the contralateral hemisphere (-0.16 +/- 0.7 s, +5.9 +/- 24.6%). In patients with stenoses >or=80% (n = 16), we found an increase in NFM ipsilateral to the stenosis of 1.2 +/- 0.92 s (P < .001) and an increase of CBV of 16.8 +/- 15.2% (P < .005). Three months postoperatively, perfusion parameters were normal in all 13 patients examined. CONCLUSIONS: Perfusion-weighted magnetic resonance imaging is well suited to evaluate the preoperative and postoperative hemodynamic changes in patients with carotid artery stenosis. This noninvasive, semiquantitative magnetic resonance technique could prove to be a valuable adjunct in identification of patients who might benefit from carotid endarterectomy.

Adult↗
PubMed2001

Carotid cavernous fistula due to a ruptured intracavernous aneurysm of the internal carotid artery: treatment with selective endovascular occlusion of the aneurysm.

Intracavernous carotid artery aneurysms causing a carotid-cavernous fistula (CCF) are rare. These aneurysms usually cause neurological symptoms due to gradual expansion without rupture. If they do rupture they most often lead to a CCF instead of bleeding into the subarachnoid space. A patient is described with a ruptured intracavernous aneurysm causing a CCF resulting in acute onset of unilateral ophthalmoplegia. Selective coil embolisation of the aneurysm led to complete occlusion of the CCF with preservation of the internal carotid artery; symptoms resolved completely.

Acute Disease↗